肝癌行RFA治疗后VEGF变化对预后影响的相关性分析

Correlation between vascular endothelial growth factor levels and prognosis of hepatocellular carcinoma patients receiving radiofrequency ablation

目的探讨肝细胞肝癌(hepatocellular carcinoma,HCC)患者行射频消融(radiofrequency ablation,RFA)治疗后血清VEGF的含量变化对预后的影响。方法经CT引导下射频消融治疗不同临床分期及特点的56例肝癌患者,经ELASA法测定术前、术后血清VEGF的含量变化,根据其中位值分阴性组、阳性组,计算其无进展生存时间(PFS),并通过ROC曲线分析VEGF对预后判断的敏感性、特异性。结果 (1)术后1周后的血清VEGF值与术前相比有下降趋势,差异有统计学意义(P <0. 05);而术后1月开始血清VEGF呈上升趋势,与术后1周比较差异有统计学意义(P<0. 05);术后3月血清VEGF与术前相比明显升高,差异具有统计学意义(P <0. 05)。(2)肝功能较差、AFP含量高的患者,其血清内VEGF含量呈较高水平,预后较差。(3)肝癌患者血清VEGF含量≥389. 9 pg/ml相对于血清VEGF含量<389. 9 pg/ml其无进展生存时间短,生存率下降,预后差;通过ROC曲线分析,术前VEGF值预测HCC预后的敏感性、特异性分别为97. 2%、90. 6%,ROC曲线下面积(AUC)为82. 2%。结论血清VEGF变化可以对HCC患者RFA术后的预后起到有效评估。

Objective:To investigate the effect of serum vascular endothelial growth factor(VEGF)levels on prognosis of hepatocellular carcinoma(HCC)patients receiving radiofrequency ablation(RFA).Methods:Fifty-six subjects with HCC undergoing CT-guided RFA were enrolled in this study.The amount of serum VEGF of all the subjects was determined before and after RFA through ELASA,on the basis of which the study subjects were divided into negative group and positive group.Then we analyzed the patient's progression-free survival time(PFS)and sensitivity,specificity of the influence on prognosis of serum VEGF through ROC curve.Results:①The amount of serum VEGF declined one week after RFA compared with before which was statistically significant(P<0.05).One month after RFA,the serum VEGF had a upward trend compared with that one week after(P<0.05).Three months after RFA,the serum VEGF increased significantly compared with that before the RFA(P<0.05).②Those subjects who had poor liver function,high level of AFP and advanced age had a correspondingly high level of VEGF and the prognosis of him or her was poor.③Those subjects whose serum VEGF level≥389.9 pg/ml had a short PFS,low survival rate and poor prognosis compared with those whose<389.9 pg/ml patients.According to the ROC curve analysis,complementarity between sensitivity and specificity were 97.2%and 90.6%respectively,and preoperative one the area under the curve(AUC)were 82.2%.Conclusion:The serum VEGF level in liver cancer patients can be used as a prognostic indicator for evaluating the efficacy of RFA treatments.